OXYGEN ASSESSMENT: DO THE NEW GUIDELINES WORK ?

SM Revill, K Burgin, D Reynolds, A Beard*, MJ Ward.

Dept of Respiratory Medicine, Sherwood Forest Hospitals NHS Trust, Nottinghamshire and * Mansfield and Ashfield PCT.

The BTS guidelines of 2006 propose a more rigorous monitoring process of patients on O2 therapy. Additionally a two-month trial of ambulatory O2 (AO) is suggested for grade 2 and 3 patients (active LTOT and active non-LTOT).

We ran O2 assessment clinics to pilot the guidelines. The aim was to provide a one-stop shop of LTOT review and AO assessments with walk tests, titration and education. Eighteen patients were reviewed:- 7 were on LTOT, 7 on short burst (SB), 2 patients qualified for AO (grade 3) and 2 patients were without any O2 therapy. Of the 7 existing LTOT patients 5 required re-titration. Of the 7 existing SB users 2 had never been assessed and were inappropriate prescriptions and one patient had deteriorated to the point of requiring LTOT. The grade 3 desaturators underwent walk tests and were given 2 month trials of AO. Of the 2 patients without O2 one fulfilled the criteria for LTOT and AO (grade 2) and one qualified for AO (grade 3).

The systematic review process was successful in detecting changes in LTOT requirements. The trials of AO (9 were performed) revealed a range of requirements from refusal to the installation of liquid O2 for high rate consumers. The new guidelines appear to be sensitive to the diverse needs of patients. 

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